Chris Andrews (Dublin Bay South, Sinn Fein)
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Scoliosis patients have a certain window in which they can be treated before treatment becomes too physically, mentally and emotionally distressing. Scoliosis is a painful and disabling condition that impacts the child and the family. Sophie Redmond is 11 years old and has scoliosis. She also has issues with her knee ligaments. I was lucky enough to meet Sophie yesterday, along with her little brother, Tyler, her father, Eric, and her mother, Sam. Sophie is like a little unicorn, bringing smiles and colour wherever she goes. Recovery from any operation to straighten the spine will require walking. However, because of Sophie's knee ligament issue she will need to have a knee operation first, which will take time to recover from. It is vital that Sophie's knees are operated on so that she will be ready for the time-sensitive scoliosis operation.

Sophie cannot cross the street unattended because of the fear that her knees might buckle, causing her to fall in the middle of the road. As a result of health system failures her spine is pressing into her lungs and pelvis. She has difficulty breathing as a result. Sophie is an 11 year old in a rapid growth phase. How bad will the Government let Sophie get? Will she be permanently physically and mentally damaged? No one can say that Sophie's condition is not impacting negatively on her mental health. Children with scoliosis cannot thrive while they are in discomfort and pain. This is a time when they are young and developing and should be thriving. An 11 year old should be physically active and enjoying the outdoors. Sophie does not want to do physical exercise because of her condition and she increasingly lacks confidence. Her confidence is taking a beating and she is constantly afraid of hurting herself.

Sophie is living in fear. She and her family are prisoners of the public health system which has failed her. The surgeries Sophie requires must be carried out in a children's hospital, as she needs specialised paediatric equipment and admittance to a children's intensive care unit, ICU. Sophie will be left crippled. If this happens, it will be on the heads of this Government and this Minister. Covid-19 cannot be used as an excuse. The Minister for Health clearly stated that he was ashamed of the waiting list for scoliosis patients. In 2018, the then Minister for Health said that no child would be on a scoliosis waiting list for more than four months.

Is the Minister of State ashamed that children like Sophie and other scoliosis patients have to wait so long for their surgery? Sophie is not a unique case. There are so many children like her waiting on scoliosis surgery. Care cannot wait and scoliosis waiting lists are unacceptable. Will the Minister of State clearly say what she will do to ensure that scoliosis sufferers like Sophie have the treatment they urgently need?

Mary Butler (Waterford, Fianna Fail)
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I would like to thank Deputy Andrews for raising this issue and for giving me the opportunity to provide the House with an update on scoliosis services for children on behalf of the Minister for Health, Deputy Stephen Donnelly.

I sincerely regret that children can experience a long waiting time for treatment for scoliosis and I am conscious of the burden this places on them and their families. This Government's priority is to improve waiting times for all patients accessing hospital treatment across all specialties, including orthopaedics. In response to the Covid-19 pandemic, Children's Health Ireland, CHI, had to take measures to defer most scheduled care activity between March and May of this year. This decision was in line with the advice issued by the National Public Health Emergency Team, NPHET, in accordance with the advice of the World Health Organization. Since June, CHI has continued to re-establish services, following HSE clinical guidelines and protocols to ensure services are provided in a safe, clinically aligned and prioritised way. CHI has advised my Department that spinal surgery continues to be identified as a service priority.

I note that infection prevention and control requirements such as social distancing of 2 m have a material impact on the physical space available for the delivery of all hospital services, including scoliosis procedures. This has had a significant impact on both available capacity and operational activity levels. Despite these challenges, by the end of October CHI had carried out 255 scoliosis procedures, 123 of which were spinal fusions and 132 of which were other spinal procedures. While this is 20% behind activity levels for the same period last year, CHI is committed to improving activity levels and is examining innovative methods to improve access to all specialties, including orthopaedics. For example, CHI is working with the Cappagh National Orthopaedic Hospital to transfer additional patients who meet the clinical criteria for treatment at Cappagh. CHI is also working with the National Treatment Purchase Fund, NTPF, to source additional theatre space to facilitate both scoliosis and wider orthopaedic demands.

In relation to the individual case referred to by the Deputy, section 6 of the Health Service Executive (Governance) Act 2013 bars the Minister for Health from directing the HSE to provide a treatment or a personal service to any individual or to confer eligibility on any individual. Officials in my Department remain in regular contact with CHI regarding scoliosis services. CHI has advised that all patients with a diagnosis of scoliosis require a pre-operative work-up prior to spinal surgery, including multiple diagnostic investigations and review by a multidisciplinary team. The plan of care implemented for each patient is tailored to best meet the patient's clinical requirements.

I am aware that parliamentary questions and public representations have been made to the Minister and the Department in respect of the specific patient referred to by the Deputy. CHI has advised my Department that the hospital is in ongoing contact with the family of the patient in relation to their surgery.

Chris Andrews (Dublin Bay South, Sinn Fein)
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I thank the Minister of State for her response. Unfortunately I did not hear any notes of hope for scoliosis patients or for Sophie. She is representative of so many children with scoliosis and the frustration that they and their families feel. The State is robbing them of their childhood because of inefficiencies in the health system. That is not something we as a Parliament should be standing over.

Like many other children, Sophie suffers from 22q11.2 deletion syndrome. This is a disorder caused when a small part of chromosome 22 is missing. This deletion results in the poor development of several body systems. The effects on every child are different. This can cause mental health issues for one child and chest or heart issues for another. Many children can have this syndrome without even knowing they have it. This adds to the problem. Many children with scoliosis also suffer from 22q11.2 deletion syndrome. It complicates their condition and adds to the urgency of treating them.

It is not just spinal surgery they need; very often they require a whole suite of surgeries, operations and treatments. Like I said at the start, I just feel that the Minister and the Department are not putting in the required resources to ensure that children with scoliosis and children such as Sophie get the treatment they need so urgently.

Mary Butler (Waterford, Fianna Fail)
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I am acutely aware of the distress and inconvenience caused to patients and their families when urgent care is delayed and I thank the Deputy for raising the case of Sophie and the fact that she is waiting for her scoliosis operation. Improving waiting times for hospital appointments and procedures remains a key commitment of the Government. The long-term strategy to develop sustainable scoliosis services remains a priority for the Minister, Deputy Donnelly, and his Department. His officials continue to work closely with Children's Health Ireland and the wider HSE to improve access to treatment for children with scoliosis.

It is acknowledged, however, that the challenges faced by the health system in 2020 are unlike anything we have ever faced before. I am very aware of the impact that Covid-19 has had on our health service and the delivery of scoliosis services. Children's Health Ireland's commitment to prioritise spinal surgery and to find new ways to deliver care exemplifies the work undertaken by the HSE to provide care in a challenging Covid-19 environment.

Officials from my Department continue to engage on an ongoing basis with representatives of CHI and HSE officials to monitor scoliosis services, waiting lists and activity levels. I welcome the work undertaken to date by Children's Health Ireland to improve access to spinal surgery.

I reiterate that the Minister is aware of the parliamentary questions he has been asked and the public representations that have been made to him and his Department in respect of the specific patient referred to by the Deputy. Children's Health Ireland has advised the Department that the hospital is in ongoing contact with the family of the patient regarding the surgery. I hope for Sophie's sake that it happens very soon.